Washington, D.C. – Today, Rep. David Rouzer (NC-07) and Rep. Joe Courtney (CT-02), co-chairs of the Congressional Primary Care Caucus, led a group of bipartisan members in writing to Health and Human Services (HHS) Secretary Alex Azar to ask for swift consideration of the Advanced Primary Care Alternative Payment Model (APC-APM), a new model for primary care payment that requires the Secretary’s approval before implementation among Medicare providers can begin.
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) which created a roadmap for transitioning Medicare providers from providing ‘high-volume’ services, to ‘high-value’ services. This roadmap consists of two paths for providers; one called the Alternative Payment Model (APM) and one called the Merit-Based Incentive Program. For providers to participate in the APM track, these models must be approved by the Secretary. The APC-APM is one model, developed by the American Association of Family Physicians, designed to improve the way Medicare pays for primary care and how patients receive care. It includes a per-member monthly payment to physicians to cover population health and in-person visits, and additional payments to cover email and phone consultations. This flexible model is designed to reduce the administrative burden associated with reporting and billing to focus more resources on patient care.
“We believe that the APC-APM proposal is consistent with the Administration’s goals of preserving independent medical practices, lowering the cost of health care, and reducing the administrative burden for physicians and other health care providers,” wrote the members. “If fully implemented, the APC-APM would allow more than 200,000 primary care physicians to engage in a payment model that promotes the value of primary care through comprehensive and continuous patient-centered primary care.”
Michael Munger, MD, president of the American Academy of Family Physicians, said “The AAFP’s APC-APM is the first payment model founded on primary care to be approved by the Physician-Focused Payment Model Technical Advisory Committee (PTAC). It is a foundational element in the movement to value-based care, as envisioned under MACRA, because it is designed to expand primary care physicians’ access to APMs—including small, independent and rural practices—and it’s designed with a standard of patient choice. We appreciate and welcome the support of the Primary Care Caucus and its leaders Reps. Joe Courtney and David Rouzer.”
The APC-APM has been approved by the MACRA-created Physician-Focused Payment Model Technical Advisory Committee (PTAC), which recommended pilot implementation of the model. Secretary Azar must approve the proposal before this testing can begin. Since the law’s passage, only one APM has been approved.